Provider Demographics
NPI:1942790613
Name:CAMPOS, SEBASTIANA MORAES (APRN)
Entity Type:Individual
Prefix:
First Name:SEBASTIANA
Middle Name:MORAES
Last Name:CAMPOS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7821 SW 129TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-6153
Mailing Address - Country:US
Mailing Address - Phone:786-262-5323
Mailing Address - Fax:
Practice Address - Street 1:10095 N KENDALL DR STE 102
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1797
Practice Address - Country:US
Practice Address - Phone:305-595-5455
Practice Address - Fax:305-243-3506
Is Sole Proprietor?:No
Enumeration Date:2018-05-17
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9219520363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily